Provider Demographics
NPI:1497277289
Name:VASQUEZ, AMOR CAROLINA
Entity Type:Individual
Prefix:MRS
First Name:AMOR
Middle Name:CAROLINA
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:AMOR
Other - Middle Name:CAROLINA
Other - Last Name:VASQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9610 57TH AVE # APART80
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-3436
Mailing Address - Country:US
Mailing Address - Phone:347-858-0060
Mailing Address - Fax:
Practice Address - Street 1:9610 57TH AVE # APART80
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-3436
Practice Address - Country:US
Practice Address - Phone:347-858-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator